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Louisiana rates for HCPCS 25622

Closed treatment of carpal scaphoid (navicular) fracture; without manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$352.26 / $1,000.00 / $3,779.00
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$256.33 / $277.20 / $445.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.29 / $369.61 / $509.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$222.57 / $492.94 / $970.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.50 / $407.28 / $503.91
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$286.06 / $298.48 / $298.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.99 / $404.70 / $545.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.00 / $543.00 / $1,560.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.04 / $327.24 / $550.13